Juvenile rheumatic arthritis. Review of 30 cases

Juvenile Rheumatic Arthritis (J.R.A) is not rare in the child. We undertook this retrospective study over a period of 19 years in tunisian children on the basis of 30 cases (17 boys and 13 girls). This represented one new case of J.R.A per 1000 hospitalisations. The W.H.O criteria of J.R.A diagnosis were present in all cases. Mean age of diagnosis was seven years with ranges between 4 months and 13 years. We specified for each patient clinic, biologic and radiological presentation. Duration of follow-up ranged between one and 18 years. We have individualized 3 forms depending of the mode of begining. Polyarthritis was the most frequent form (50 per cent), followed by pauciarthritis (26.6 per cent) and systemic form (23.3 per cent). Systemic form was characterised by the association in all patients of intense systemic features and arthritis. In the course of the first five years, exacerbations of J.R.A were frequent and death occured in two cases, deceased from renal amyloidis. Polyarthritis's course was safe of articular destruction despite frequency of articular deformations (ten cases). Pauciarthritis had good articular prognosis with no ocular complications. We point out to the importance of early diagnosis and treatment of J.R.A in the child to avoid articular deformations and bone destruction.